Outcomes after Apheresis in patients with underlying Heart Failure: A Propensity Matched National Cohort Analysis

Objectives: Evaluate in-hospital outcomes of apheresis in patients with heart failure. Background: Estimating volume replacement with apheresis in heart failure patients can be challenging. Available data is limited in scope and not sufficiently available regarding the in-hospital outcomes of apheresis in patients with heart failure. Apheresis is an extracorporeal therapy that removes specific constituents from the blood or plasma and returns the remainder into circulation. It has become a diverse method of treating a wide array of familial and autoimmune diseases.2 Over 15,000 patients worldwide received apheresis from 2014 to 2018 due to its versatility in treating different conditions. The target of this study was to evaluate in-hospital outcomes of apheresis in patients with heart failure. Methods: A retrospective cohort study of the National Inpatient Sample (NIS) database from 2016 to 2018 comparing apheresis in patients with and without underlying HF diagnosis. Adults (18 yrs.) were identified who had undergone apheresis. The primary outcome was in-hospital mortality. Secondary outcomes included acute kidney injury, cerebrovascular accident, major bleeding, sudden cardiac arrest, cardiogenic shock, mechanical circulatory support, mechanical ventilation, calcium abnormalities, fluid and electrolyte disturbances, coagulation abnormalities, and severe sepsis. Results: Apheresis in patients with HF had a higher percentage of in-hospital mortality, acute kidney injury, major bleeding, cardiogenic shock, mechanical circulatory support, mechanical ventilation, calcium abnormalities, fluid and electrolyte disturbances, coagulation abnormalities, and severe sepsis. No significant difference was found in CVA and sudden cardiac arrest. The length of stay in the heart failure group was 12 days vs. 7 days for patients with no heart failure. The median charges for apheresis without HF and apheresis with HF were $95,269 and $186,591, respectively. Conclusion: Apheresis is associated with increased in-hospital mortality, acute kidney injury, major bleeding, cardiogenic shock, mechanical circulatory support, mechanical ventilation, calcium abnormalities, fluid and electrolyte disturbances, coagulation abnormalities, and severe sepsis in HF patients. HF is also associated with a higher cost and longer length of hospital stay.

Grantor dc:publisher

University of Kansas

Year dc:date.issued

2022

Author dc:creator

• Tiwari, Ankita

Advisor dc:contributor.advisor

• Choi, Won

• Medicine
• Apheresis
• cardiomyopathy
• Heart failure
• HFpEF
• HFrEF
• inpatient

Statement dc:rights

• Copyright held by the author.

Language dc:language.iso

en

Dc Identifier Other

http://dissertations.umi.com/ku:18719

OAI identifier oai:identifier

oai:kuscholarworks.ku.edu:1808/37311